加速康复外科理念结合中医针刺治疗腹腔镜胃癌根治术患者胃肠功能障碍

Accelerated rehabilitation surgery combined with acupuncture in the treatment of gastrointestinal dysfunction of patients received laparoscopic radical gastrectomy

目的探讨加速康复外科理念结合中医针刺治疗腹腔镜胃癌根治术患者胃肠功能障碍的临床疗效。方法采用回顾性研究方法,将2018年6月至2020年6月收治的92例行腹腔镜胃癌根治术的患者分为观察组(n=46)和对照组(n=46)。对照组给予西医常规治疗,观察组在西医常规治疗基础上辅以针刺治疗,每日1次,每次30 min。观察两组患者肛门首次排气时间、肛门首次排便时间、肠鸣音恢复时间、进食流质食物时间、VAS评分、I-FEED评分及平均住院日的差异,并对两组的总有效率进行比较。结果观察组的肛门首次排气时间、肛门首次排便时间、肠鸣音恢复时间、进食流质食物时间及平均住院日均少于对照组(P<0.01,P<0.05),术后VAS评分、I-FEED评分显著低于对照组(P<0.01,P<0.05),总有效率显著高于对照组,差异有统计学意义(P<0.05)。结论加速康复外科理念结合中医针刺应用于腹腔镜胃癌根治术患者术后康复,临床疗效肯定,可以有效缩短治疗时间,缓解术后疼痛,促进早期胃肠功能的恢复,达到快速康复的目的。

Objective To explore the clinical effect of enhanced recovery after surgery(ERAS)combined with acupuncture on postoperative gastrointestinal dysfunction(POGD)in patients received laparoscopic radical gastrectomy.Methods A retrospective study was performed on 92 patients received laparoscopic radical gastrectomy,and the patients were divided into observation group and control group(n=46,each).Conventional western medicine treatment was given in control group,and acupuncture was conducted in observation group on the basis of conventional western medicine.The first anal exhaust time,the first defecation time,the recovery time of bowel sounds,first time eating liquid food,visual analog score(VAS),I-FEED score(for postoperative gastrointestinal function)and average length of stay were observed to compared the total effective rate between two groups.Results The first anal exhaust time,the first defecation time,the recovery time of bowel sounds,time of eating liquid food and average hospital stay in observation group were significantly shorter than those in control group(P<0.05),and postoperative VAS score and I-FEED score were significantly lower than those in control group(P<0.05).The total effective rate in observation group was significantly higher than that in control group(P<0.05).Conclusion For the postoperative rehabilitation of patients received laparoscopic radical gastrectomy,accelerated rehabilitation surgery combined with acupuncture has definite clinical effect and can effectively shorten the treatment time,relieve postoperative pain,promote early recovery of gastrointestinal function and achieve the goal of rapid rehabilitation.